By Russ Britt

Look for shares of Intuitive Surgical to take a deep dive Wednesday morning as the maker of robotic surgical systems warned late Tuesday that first-quarter revenue would be lower than expected, and the company is taking a charge against earnings.

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French surgeon Alain Herard with Intuitive’s da Vinci robotic surgeon

Intuitive
/quotes/zigman/90651/delayed/quotes/nls/isrgISRG, whose high-flying stock lately has been trading near $500, saw its shares drop more than 1% before the close and nearly 10% more after hours. Shares stood at $444.10 in recent action, down nearly $53 apiece from Tuesday’s open of $497.03.

The company reported after the bell it expects first-quarter revenue to come in at $465 million, 24% lower than the $611 million from the same period a year ago and more than 8% off the $535.5 million expected from analysts polled by FactSet.

Part of the problem is Intuitive is taking a hit on trade-ins for those upgrading to its new da Vinci Xi surgical system. Without that, however, revenue still would have been $491 million, 8% short of forecasts.

The main issue is falling sales for the Xi’s predecessor, the older da Vinci systems. Sales of those are expected to be down 59% to roughly $106 million. Intuitive attributed that to fewer procedures and Obamacare-related changes in hospital spending priorities.

Intuitive shares made a similarly sharp move downward in July after the company warned earnings would be lower than expected for the second quarter of 2013. Shares were hovering around the $500 level and quickly fell to below $400. They languished between $350 and $400 until early this year.

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Health Exchange guides investors to the crucial market intelligence they need to keep up with the health care industry, which makes up one-sixth of the U.S. economy. Anchored by Russ Britt, Health Exchange is the essential site for those looking for the most important news, data and analysis on the sector. You can reach Russ at Rbritt@marketwatch.com.